Hot Work Permit and Shutdown Request

This form must be submitted to allow at least 2 full working days between the day the request is submitted and the day requested for the shutdown. (i.e. submit on Monday for a Thursday shutdown.) This time is needed for proper routing and approval. This form will be emailed directly to Risk Management Services and FM Fire Safety for approval. For a request less then 2 full working days in the future, please fill out the form and then call Risk Management at 621-1790 for Hotwork permit or Fire Safety at 626-6657 for a shutdown request.  Failing to call  will result in the request being denied.

Applicant Information

UA Project Manager Information

UA Department , FM Shop or Contractor Performing Work Information

Emergency Contacts

Billing Information

Work Information

Have you read, understood, and have taken the required precautions as outlined on the Fire Safety precautions checklist?